what it's like to be deaf

Over the past six months or so, I have had to face up to the fact that I need a hearing aid. I'm deaf in my right ear. Nearly 60% deaf. It's strange-- I thought it was "just wax" and when Joan, the Nurse Practitioner at the Family Health Network reamed out my ears, I thought she hadn't done a complete job, since I still couldn't hear well out of my right ear. Noooo.... she said, "go to an audiologist". So off I went to Canada Hears and lo and behold, I really couldn't hear. Hearing aid time.

Hey, only old people have hearing aids. Not so, as my daughter pointed out, some of her best friends have had hearing aids since they were little. I felt very Politically Incorrect. And old. But given the family history of osteoarthritis (in the ear???), it's not that surprising. Unlike my uncle Leopold Kohr, who was stone deaf and most annoying -- and must have been frustrated himself, because his hearing aid, that looked like some sort of big recording device he'd hold up to your face (someone at a cocktail party once leaned into it and said "testing, testing, one, two, three" assuming it was, in fact, going to record him, as Uncle Poldi merely was trying to hear him better). Anyway, I'm not STONE deaf, just on the right side.

So, stand to my left, wouldya?

commemorating my mother

My mother was an amazing woman. She was a pharmacist, with a BSc in Pharmacy from University of Toronto in the 1930s, with only a few other women in her class. She was a business woman, entrepreneur, involved in the Canadian Consumers' Association, drove a Karman Ghia convertible, and was working on a Real Estate License when she became ill with what turned out to be ovarian cancer.

She was 54 when she died, a year after being diagnosed. As a 17 year old, I was not prepared for my mother's demise. In fact, I didn't realize she was dying until a few weeks before she actually died. Up until then, I assumed she was just sick & would recover and come home. Almost a year in the hospital, she wasted away until even as a self-centred teen-ager, I could no longer avoid the inevitable truth. She was going to die.

When I look at the list of famous women who have died of ovarian cancer, the most obvious thing is how young they were when they died; mostly in their forties, fifties and early sixties. What does this do to families, whose main anchor is taken away? I know what happened to our family. It was very, very hard.

If I was in a position to create a foundation, it would be in the memory of my mother and other women like her: hard working, loving, energetic role-models for their children and those around them--and taken away half a century too soon.

Some day, I hope I can do this. Ovarian cancer is still the deadly silent killer, that destroys families by taking away mothers, wives, sisters.
What can we do to win this battle?

Palliative care: on death's doorstep??

There seems to be a mis-understanding that if someone needs Palliative Care (in the hospital), they might as well be heading to the cemetery. I have these discussions with people sometimes, where they look anxious & worried when the word "Palliative" is mentioned. As healthcare providers, we work hard to deal with pain in particular, to try to help patients get what they need. And as it becomes obvious to us that someone is likely not going to recover, and is, in fact, deteriorating... that's when the thought of Palliative Care comes to mind.
I have friends who are part of the Palliative Care team and I suspect they feel mis-understood when people refuse the offer of their services, because they think of Palliative Care as being at the very final end of life. But we have many patients who receive much better pain management, and other symptom management (nausea, constipation,etc) because the Palliative Care team are experts in making those subtle combinations of drugs work well--and keep people as functional and comfortable as possible.
As well, they are the ones whose kind and gentle faces, hands and voices are there to provide solace and support during what can be a long, exhausting process of moving from life to death. A natural thing, but still very hard to accept for many people.

passport photos

I went to have my passport photo taken today. My passport is due to expire, and rather than go through the effort (and detail required) to have a whole new passport, I thought I'd actually be organized enough to get the few things I need for the renewal. One of these was the photo.

My friend Christine told me that the little post office around the corner does passport photos for about $10., which was half what Black's charges. So I went there. Had my picture taken by an elderly man who had set up the photo area like a Karsh studio. The lights, the bounce-foil umbrella, the white board to hold on my lap to deal with the shadows under my chin (fleetingly worried that this might be just my chin(s)).

And the result: I look less like a terrorist/escaped convict and more like a disgruntled housewife. Sad, but true. The photographer said, "Try to put more softness in your eyes", since I clearly was forbidden to smile--now that we are all suspect if we look pleasant & happy.

Unfortunately, I don't think, unless you're a trained model, that looking pleasant while forcing a solemn expression somewhere between grim and unhappy, can do the trick. Oh well, at least it's done and I can get on with the next step in the process...

Now I just need to find my birth certificate. Where did I put that thing???

Learned Helplessness

There seems to be a culture of letting the experts make the decisions in healthcare... and it's to the detriment of the critical thinking skills nurses have learned and developed in their educational and experiential programs. I recall Seligman's idea of "Learned Helplessness" as a theory that explained how people seem to give up/allow others to make decisions. Although a good portion of this is in relation to depression, it also applies to how people learn from others who model the behaviour.

Nurses generally work in groups and my observation is that the "new" nurses to the unit want to fit in, and want to develop a style that is congruent with the overall style of the unit (often not an official style, but the way the natural leaders of the unit behave). If it's the norm to defer to the expertise of others, then that's the way it works. While this is fine if the nursing knowledge might actually be limited, I find it puzzling that for chronic wound care, nurses will wait for the MD to write orders before even looking at the wound.

This strikes me as odd, since nurses need to assess the whole patient in order to identify nursing-relevant plans of care & to wait for the doctor to open/assess the wound implies that the nurse can't do this him/herself. Last time I checked, this was within the realm of practice of nurses (in Ontario, anyway). So, why not do it?

I think it's that sense of not really knowing what to do...that someone else has more expertise--even when they actually don't, or when the nurse does have enough knowledge to figure out what might be an appropriate treatment (unless it's a particularly complex situation). But I've had nurses say to me that they "need" an order for a chronic wound dressing, as if they are unable to make observations and suggestions themselves.

Not that I'm trying to work my way out of a job (although that would be gratifying, if every nurse knew what needed to be done, and felt comfortable/confident to do it, for those garden-variety chronic wounds). And I guess, if we could get over the feeling that somehow we just aren't quite capable...